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Farr Z, Broomfield NM, Coventry KR. A Systematic Review of Attentional Bias in Problem Gambling. J Gambl Stud 2024; 40:493-519. [PMID: 37943393 PMCID: PMC11272818 DOI: 10.1007/s10899-023-10260-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/15/2023] [Indexed: 11/10/2023]
Abstract
A large body of previous research has provided support for the role of attentional bias as a maintaining factor in addiction. This systematic review aimed to investigate the extent and nature of attentional bias as a phenomenon which exists within problem gamblers. Studies were identified through searches of three databases (MedLine, PSYCHINFO, and Web of Science) and examination of the reference lists of the final studies meeting criteria for inclusion. The scope of the review included empirical studies making experimental comparisons of problem gamblers and non-problem gamblers across a range of attentional paradigms. A comparison of effect sizes was conducted across studies comparing problem to non-problem gamblers within and between attention paradigms. Twenty-two studies were reviewed systematically across ten experimental paradigms. Attentional bias was demonstrated in 16 of the 22 studies, with attentional bias effects varying across paradigms. Quality assessment revealed two main limitations across studies: lack of a priori power analysis, and failure to control for gambling frequency as a possible confounding variable. Findings support the role of attentional bias as a potential maintaining factor in problem gambling behaviour, in line with evidence for substance addiction. Recommendations for future studies are outlined alongside a discussion of clinical implications.
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Affiliation(s)
- Zoe Farr
- Department of Clinical Psychology, Norwich Medical School, University of East Anglia, Norwich, UK.
| | - Niall M Broomfield
- Department of Clinical Psychology, Norwich Medical School, University of East Anglia, Norwich, UK
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Ciccarelli M, Pizzini B, Griffiths MD, Cosenza M, Nigro G, D'Olimpio F. Attentional disengagement, craving, and mentalizing: a preliminary experimental study among older-aged male gamblers. BMC Psychol 2024; 12:164. [PMID: 38504324 PMCID: PMC10949650 DOI: 10.1186/s40359-024-01651-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 03/07/2024] [Indexed: 03/21/2024] Open
Abstract
INTRODUCTION Empirical studies have demonstrated the role that attentional bias, the mutual excitatory relationship between attentional bias and craving, and mentalizing play in problem gambling. Although problem gambling rates among older-aged adults have steadily increased in recent years, research studies among this cohort are scarce. The present study is the first to empirically investigate attentional bias, as well as the joint role of attentional bias, craving, and mentalizing among older-aged gamblers. METHOD Thirty-six male older-aged gamblers were administered the South Oaks Gambling Screen (SOGS), the Gambling Craving Scale (GACS), and the Reflective Functioning Questionnaire (RFQ-8) to assess gambling severity, craving levels, and mentalizing, respectively. Participants also performed a modified Posner Task to investigate attentional biases. RESULTS Hierarchical linear regression analysis showed that among older-aged male gamblers, GACS Anticipation and RFQ-8 Uncertainty about mental states, as well as disengagement bias at 100 ms, significantly predicted gambling severity. CONCLUSION The present study provides the first empirical support for the role of attentional bias, craving, and mentalizing among older-aged gambling. More specifically, a difficult in disengaging attention away from gambling, the anticipation of pleasure deriving from gambling, and hypomentalizing predicted gambling severity among older-aged gamblers. The findings make an important contribution, by identifying the factors responsible for problem gambling among this specific age cohort and suggesting that timely interventions for mentalizing and attentional bias may be necessary to prevent problem gambling in old age.
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Affiliation(s)
- Maria Ciccarelli
- Department of Psychology, Università degli studi della Campania "Luigi Vanvitelli", Viale Ellittico, 31, Caserta, 81100, Italy.
| | - Barbara Pizzini
- Università Giustino Fortunato, Via Raffaele Delcogliano, 12, Benevento, 82100, Italy
| | - Mark D Griffiths
- Psychology Department, Nottingham Trent University, 50 Shakespeare Street, Nottingham, NG1 4FQ, UK
| | - Marina Cosenza
- Department of Psychology, Università degli studi della Campania "Luigi Vanvitelli", Viale Ellittico, 31, Caserta, 81100, Italy
| | - Giovanna Nigro
- Department of Psychology, Università degli studi della Campania "Luigi Vanvitelli", Viale Ellittico, 31, Caserta, 81100, Italy
| | - Francesca D'Olimpio
- Department of Psychology, Università degli studi della Campania "Luigi Vanvitelli", Viale Ellittico, 31, Caserta, 81100, Italy
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Wang Y, Zuo J, Hao W, Wu L, Liu F, Wang Q, He L, Peng P, Zhou Y, Li M, Yang Q, Wang X, Liu T, Potenza MN. Relationships Between Impulsivity, Methamphetamine use Disorder and Gambling Disorder. J Gambl Stud 2023; 39:1635-1650. [PMID: 36973505 DOI: 10.1007/s10899-023-10201-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2023] [Indexed: 03/29/2023]
Abstract
Methamphetamine use disorder (MAUD) and gambling disorder (GD) frequently co-occur. Individuals with both conditions are typically more difficult to treat than those with either disorder alone. This study aimed to investigate the co-occurrence and clinical characteristics of people with MAUD and GD. Between March 2018 and August 2020, 350 men with methamphetamine use entering a compulsory drug rehabilitation center in Changsha, Hunan Province received semi-structured interviews. Participants completed the Barratt Impulsiveness Scale-11 and provided information on childhood upbringings and drug use characteristics. Independent sample t-tests compared differences between individuals with MAUD and with and without co-occurring GD. Dichotomous logistic regression was used to statistically predict co-occurring GD. The prevalence of GD was 45.1%. Most individuals (39.1% overall) had post-onset methamphetamine use (PoMAU-GD). The number of MAUD symptoms, history of gambling by family members, age of first sexual activity, and non-planning impulsivity statistically predicted PoMAU-GD, jointly explaining 24.0% of the total variance. The regression model fit well (HLχ2 = 5.503, p = 0.70), in which the specificity was 0.80, the sensitivity was 0.64, and the area under the curve was 0.79 (95%CI: 0.75-0.84). This study clarifies the prevalence of and potential risk factors for GD among individuals engaging in compulsory MAUD treatment in China. The high prevalence and associated clinical features of GD in the MAUD group highlight the importance of screening for GD in this population and intervening accordingly.
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Affiliation(s)
- Yingying Wang
- School of Physical Education and Health, Hunan University of Technology and Business, Changsha, China
- Department of Psychiatry, The Second Xiangya, National Clinical Research Center for Mental Disorders, Hospital of Central South University, Changsha, China
| | - Jinsong Zuo
- Department of Psychiatry, The Second Xiangya, National Clinical Research Center for Mental Disorders, Hospital of Central South University, Changsha, China
- School of Life Science and Chemistry, Hunan University of Technology, Zhuzhou, China
| | - Wei Hao
- Department of Psychiatry, The Second Xiangya, National Clinical Research Center for Mental Disorders, Hospital of Central South University, Changsha, China
| | - Lingxiang Wu
- School of Science, Shaoyang University, Shaoyang, China
| | - Feng Liu
- Compulsory detoxification center of Changsha Public Security Bureau, Changsha, Hunan, China
| | - Qianjin Wang
- Department of Psychiatry, The Second Xiangya, National Clinical Research Center for Mental Disorders, Hospital of Central South University, Changsha, China
| | - Li He
- Department of Psychiatry, The Second Xiangya, National Clinical Research Center for Mental Disorders, Hospital of Central South University, Changsha, China
| | - Pu Peng
- Department of Psychiatry, The Second Xiangya, National Clinical Research Center for Mental Disorders, Hospital of Central South University, Changsha, China
| | - Yanan Zhou
- Department of Psychiatry, Brain Hospital of Hunan Province (The Second People's Hospital of Hunan Province), Changsha, China
| | - Manyun Li
- Department of Psychiatry, The Second Xiangya, National Clinical Research Center for Mental Disorders, Hospital of Central South University, Changsha, China
| | - Qian Yang
- Department of Psychiatry, The Second Xiangya, National Clinical Research Center for Mental Disorders, Hospital of Central South University, Changsha, China
| | - Xin Wang
- Department of Psychiatry, The Second Xiangya, National Clinical Research Center for Mental Disorders, Hospital of Central South University, Changsha, China
| | - Tieqiao Liu
- Department of Psychiatry, The Second Xiangya, National Clinical Research Center for Mental Disorders, Hospital of Central South University, Changsha, China.
| | - Marc N Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
- Child Study Center, Yale University School of Medicine, New Haven, CT, USA.
- Connecticut Council on Problem Gambling, Wethersfield, CT, USA.
- Connecticut Mental Health Center, New Haven, CT, USA.
- Department of Neuroscience, Yale School of Medicine, New Haven, CT, USA.
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van Ruitenbeek P, Franzen L, Mason NL, Stiers P, Ramaekers JG. Methylphenidate as a treatment option for substance use disorder: a transdiagnostic perspective. Front Psychiatry 2023; 14:1208120. [PMID: 37599874 PMCID: PMC10435872 DOI: 10.3389/fpsyt.2023.1208120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 07/14/2023] [Indexed: 08/22/2023] Open
Abstract
A transition in viewing mental disorders from conditions defined as a set of unique characteristics to one of the quantitative variations on a collection of dimensions allows overlap between disorders. The overlap can be utilized to extend to treatment approaches. Here, we consider the overlap between attention-deficit/hyperactivity disorder and substance use disorder to probe the suitability to use methylphenidate as a treatment for substance use disorder. Both disorders are characterized by maladaptive goal-directed behavior, impaired cognitive control, hyperactive phasic dopaminergic neurotransmission in the striatum, prefrontal hypoactivation, and reduced frontal cortex gray matter volume/density. In addition, methylphenidate has been shown to improve cognitive control and normalize associated brain activation in substance use disorder patients and clinical trials have found methylphenidate to improve clinical outcomes. Despite the theoretical basis and promising, but preliminary, outcomes, many questions remain unanswered. Most prominent is whether all patients who are addicted to different substances may equally profit from methylphenidate treatment.
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Affiliation(s)
- Peter van Ruitenbeek
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
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Wolfschlag M, Håkansson A. Drug-Induced Gambling Disorder: Epidemiology, Neurobiology, and Management. Pharmaceut Med 2023; 37:37-52. [PMID: 36611111 PMCID: PMC9825131 DOI: 10.1007/s40290-022-00453-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2022] [Indexed: 01/09/2023]
Abstract
Problematic gambling has been suggested to be a possible consequence of dopaminergic medications used mainly in neurological conditions, i.e. pramipexole and ropinirole, and possibly by one antipsychotic compound, aripiprazole. Patients with Parkinson's disease, restless legs syndrome and other conditions potentially treated with dopamine agonists, as well as patients treated for psychotic disorders, are vulnerable patient groups with theoretically increased risk of developing gambling disorder (GD), for example due to higher rates of mental ill-health in these groups. The aim of the present paper is to review the epidemiological, clinical, and neurobiological evidence of the association between dopaminergic medications and GD, and to describe risk groups and treatment options. The neurobiology of GD involves the reward and reinforcement system, based mainly on mesocorticolimbic dopamine projections, with the nucleus accumbens being a crucial area for developing addictions to substances and behaviors. The addictive properties of gambling can perhaps be explained by the reward uncertainty that activates dopamine signaling in a pathological manner. Since reward-related learning is mediated by dopamine, it can be altered by dopaminergic medications, possibly leading to increased gambling behavior and a decreased impulse control. A causal relationship between the medications and GD seems likely, but the molecular mechanisms behind this association have not been fully described yet. More research is needed in order to fully outline the clinical picture of GD developing in patient groups with dopaminergic medications, and data are needed on the differentiation of risk in different compounds. In addition, very few interventional studies are available on the management of GD induced by dopaminergic medications. While GD overall can be treated, there is need for treatment studies testing the effectiveness of tapering of the medication or other gambling-specific treatment modalities in these patient groups.
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Affiliation(s)
- Mirjam Wolfschlag
- Malmö-Trelleborg Addiction Center, Competence Center Addiction, Region Skåne, Södra Förstadsgatan 35, plan 4, S-205 02 Malmö, Sweden ,Faculty of Medicine, Dept of Clinical Sciences Lund, Lund University, Psychiatry, Lund, Sweden
| | - Anders Håkansson
- Malmö-Trelleborg Addiction Center, Competence Center Addiction, Region Skåne, Södra Förstadsgatan 35, plan 4, S-205 02, Malmö, Sweden. .,Faculty of Medicine, Dept of Clinical Sciences Lund, Lund University, Psychiatry, Lund, Sweden.
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O'Malley KY, Hart CL, Casey S, Downey LA. Methamphetamine, amphetamine, and aggression in humans: A systematic review of drug administration studies. Neurosci Biobehav Rev 2022; 141:104805. [PMID: 35926727 DOI: 10.1016/j.neubiorev.2022.104805] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 07/24/2022] [Accepted: 07/30/2022] [Indexed: 10/16/2022]
Abstract
The relationship between amphetamine use and aggressive or violent behaviour is unclear. This review examined laboratory data collected in humans, who were administered an acute dose of amphetamine or methamphetamine, in order to investigate the link between amphetamines and aggression. It is registered with PROSPERO (CRD42019127711). Included in the analysis are data from twenty-eight studies. Behavioural and/or subjective measures of aggression were assessed in one thousand and sixty-nine research participants, with limited amphetamine-use histories, following a single amphetamine dose (0-35mg). The available published evidence indicates that neither amphetamine nor methamphetamine acutely increased aggression as assessed by traditional laboratory measures. Future research should assess supratherapeutic amphetamine doses as well as include a broader range of multiple aggression measures, facilitating simultaneous assessment of the various components that comprise this complex, multifaceted construct.
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Affiliation(s)
- Kate Y O'Malley
- Centre for Human Psychopharmacology, Swinburne University, 427-451 Burwood Road Hawthorn, Victoria, Australia 3122; Department of Psychology, Columbia University, 1190 Amsterdam Avenue, 406 Schermerhorn, MC 5501, New York, NY 10027.
| | - Carl L Hart
- Department of Psychology, Columbia University, 1190 Amsterdam Avenue, 406 Schermerhorn, MC 5501, New York, NY 10027; Division on Substance Use, New York State Psychiatric Institute, and Department of Psychiatry, 1051 Riverside Drive, MC 120, New York, NY 10032
| | - Sharon Casey
- Centre for Human Psychopharmacology, Swinburne University, 427-451 Burwood Road Hawthorn, Victoria, Australia 3122; Centre for Investigative Interviewing, Griffith, 176 Messines Ridge Road, Mount Gravatt, QLD, 4122
| | - Luke A Downey
- Centre for Human Psychopharmacology, Swinburne University, 427-451 Burwood Road Hawthorn, Victoria, Australia 3122; Institute for Breathing and Sleep, Austin Hospital, 145 Studley Road Heidelberg, Victoria, Australia 3084
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Miller L, Söderpalm Gordh A. Subjective and Cardiovascular Responses to an Acute Laboratory Gambling Task in Men and Women. Front Psychiatry 2022; 13:702298. [PMID: 35733803 PMCID: PMC9207275 DOI: 10.3389/fpsyt.2022.702298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 05/04/2022] [Indexed: 11/20/2022] Open
Abstract
Men have previously been overrepresented in gambling for money but in recent years there has been an increase in recognition that women who gamble are "catching up" with their male counterparts. There have been few experimental studies investigating the subjective effects of gambling, and even less have explored the gender differences. As gender differences previously have been reported in the subjective effects of several drugs of abuse such as opioids, amphetamines and alcohol, we sought to investigate if the subjective effects of gambling also differed by gender. The present article analyzes if gender modulates the subjective and physiological effects of an acute laboratory gambling task in healthy men and women. Eighty-two men and women (n = 35 men, n = 47 women) were tested with an online slot machine gambling session and self-report questionnaires of mood and blood pressure were taken before and after gambling. Both men and women showed stimulatory effects of gambling i.e., feelings of high and euphoria and but no differences were found between genders. Findings suggest that both men and women equally experience a pattern of stimulatory effects of gambling from the gambling situation. Gambling therefore seems to have the same abuse potential in both men and women. Although the gap between men and women is narrowing, immediate subjective and physiologic responses do not explain gender differences in the epidemiology of pathological gambling. The contexts and factors that foster or hinder the evolution of gambling addiction in males and females should be further explored. This conclusion is interesting in light of that men are over three times more at risk to experience gambling related problems than women and this risk may depend on other factors involved in the development of addiction.
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Affiliation(s)
- Louise Miller
- Addiction Biology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Anna Söderpalm Gordh
- Addiction Biology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.,Department of Addiction and Dependency, Sahlgrenska University Hospital, Gothenburg, Sweden
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8
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van Ruitenbeek P, Quaedflieg CWEM, Hernaus D, Hartogsveld B, Smeets T. Dopaminergic and noradrenergic modulation of stress-induced alterations in brain activation associated with goal-directed behaviour. J Psychopharmacol 2021; 35:1449-1463. [PMID: 34519561 PMCID: PMC8652367 DOI: 10.1177/02698811211044679] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
BACKGROUND Acute stress is thought to reduce goal-directed behaviour, an effect purportedly associated with stress-induced release of catecholamines. In contrast, experimentally increased systemic catecholamine levels have been shown to increase goal-directed behaviour. Whether experimentally increased catecholamine function can modulate stress-induced reductions in goal-directed behaviour and its neural substrates, is currently unknown. AIM To assess whether and how experimentally induced increases in dopamine and noradrenaline contribute to the acute stress effects on goal-directed behaviour and associated brain activation. METHODS One hundred participants underwent a stress induction protocol (Maastricht acute stress test; MAST) or a control procedure and received methylphenidate (MPH) (40 mg, oral) or placebo according to a 2 × 2 between-subjects design. In a well-established instrumental learning paradigm, participants learnt stimulus-response-outcome associations, after which rewards were selectively devalued. Participants' brain activation and associated goal-directed behaviour were assessed in a magnetic resonance imaging scanner at peak cortisol/MPH concentrations. RESULTS The MAST and MPH increased physiological measures of stress (salivary cortisol and blood pressure), but only MAST increased subjective measures of stress. MPH modulated stress effects on activation of brain areas associated with goal-directed behaviour, including insula, putamen, amygdala, medial prefrontal cortex, frontal pole and orbitofrontal cortex. However, MPH did not modulate the tendency of stress to induce a reduction in goal-directed behaviour. CONCLUSION Our neuroimaging data suggest that MPH-induced increases in dopamine and noradrenaline reverse stress-induced changes in key brain regions associated with goal-directed behaviour, while behavioural effects were absent. These effects may be relevant for preventing stress-induced maladaptive behaviour like in addiction or binge eating disorder.
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Affiliation(s)
- Peter van Ruitenbeek
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands,Peter van Ruitenbeek, Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Universiteitssingel 40, Maastricht 6229 ER, The Netherlands.
| | - Conny WEM Quaedflieg
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Dennis Hernaus
- Department of Psychiatry and Neuropsychology, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands
| | - Bart Hartogsveld
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Tom Smeets
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands,CoRPS – Center of Research on Psychological and Somatic Diseases, Department of Medical and Clinical Psychology, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, Noord-Brabant, The Netherlands
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Widinghoff C, Berge J, Hakansson A. Psychiatric Drug Prescription and Temporal Associations with a First Diagnosis of Gambling Disorder—Results from a National Register Study. Int J Ment Health Addict 2021. [DOI: 10.1007/s11469-021-00636-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
AbstractPsychiatric comorbidity is common in gambling disorder (GD), but there are few studies on larger nationwide samples of treatment-seeking patients. Also, temporal associations between GD and other psychiatric disorders are often difficult to study. To address the prevalence and the temporal associations of prescriptions for psychiatric disorders — both in specialized care and primary care — in patients with a GD diagnosis (ICD-10 F63.0). Data was derived from national health registers in Sweden. All patients who were diagnosed with GD in specialized health care in 2005–2016 were included and run against the nationwide database on prescription of pharmaceuticals aimed for psychiatric disorders (n = 2018). Prevalence of psychiatric drug prescription was used as a proxy for psychiatric comorbidity and studied for two 2-year periods (period 1 and 2) prior to GD and one 2-year period (period 3) after the diagnosis. Controlling for gender, age, and time periods, for eight drug categories (anti- epileptics, anti-psychotics, benzodiazepine derivatives, anxiolytics, hypnotics, anti- depressants and drugs used in addictive disorders), significant increases in drug prescription were seen. For central stimulants, a significant increase was seen upon receiving the GD diagnosis (from period 2 to 3), and for benzodiazepines, an increase was seen prior to the GD diagnosis (from period 1 to 2), but not upon diagnosis (from period 2 to 3). Psychiatric comorbidity in GD is common. Drug prescription for psychiatric problems increased markedly in the years temporarily associated with a first diagnosis of GD. The findings may call for early screening for problem gambling in patients with treatment contacts for increasingly poor mental health.
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Increased risk for developing gambling disorder under the treatment with pramipexole, ropinirole, and aripiprazole: A nationwide register study in Sweden. PLoS One 2021; 16:e0252516. [PMID: 34061895 PMCID: PMC8168838 DOI: 10.1371/journal.pone.0252516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 05/17/2021] [Indexed: 11/24/2022] Open
Abstract
Gambling Disorder (GD) has recently been reclassified from an impulse-control disorder to a behavioural addiction and, as in other addictive disorders, the dopaminergic reward system is involved. According to neuroimaging studies, alterations within the striatal dopaminergic signalling can occur in GD. However, the findings to date are controversial and there has been no agreement yet on how the reward system is affected on a molecular basis. Within the last 20 years, there has been growing evidence for a higher risk to develop GD in response to certain dopaminergic medication. Especially the dopamine agonists pramipexole and ropinirole, and the dopamine modulator aripiprazole seem to increase the likelihood for GD. The goal of this study was to examine the association between a prescription for either of the three pharmaceuticals and a GD diagnosis in a large cross-sectional study of the Swedish population. Compared to patients with any other dopaminergic drug prescription (38.7% with GD), the diagnosis was more common in patients with a dopamine agonist prescription (69.8% with GD), resulting in an odds ratio of 3.2. A similar association was found between aripiprazole prescriptions and GD diagnoses, which were analysed within the subgroup of all patients with schizophrenia or a schizotypal, delusional, or another non-mood psychotic disorder. An aripiprazole prescription increased the likelihood of GD (88.8%) in comparison to patients without an aripiprazole prescription (71.2%) with an odds ratio of 3.4. This study contributes to the increasingly reliable evidence for an association between several dopaminergic drugs and a higher risk for developing GD. Therefore, one future research goal should be a better understanding of the neurobiology in GD to be able to design more selective dopaminergic medication with less severe side effects. Additionally, this knowledge could enable the development of pharmacotherapy in GD and other addictive disorders.
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Bilevicius E, Single A, Baumgartner C, Bui V, Kempe T, Schaub MP, Stewart SH, MacKillop J, Hodgins DC, Wardell JD, O'Connor R, Read J, Hadjistavropoulos H, Sundstrom C, Keough MT. Developing and testing the effectiveness of a novel online integrated treatment for problem gambling and tobacco smoking: a protocol for an open-label randomized controlled trial. Trials 2020; 21:937. [PMID: 33213506 PMCID: PMC7678080 DOI: 10.1186/s13063-020-04867-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Accepted: 11/03/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Gambling and tobacco smoking are highly comorbid among North American adults. However, there is a paucity of treatment options that are integrated (i.e. targeting both gambling and tobacco smoking simultaneously), accessible, and evidence based. METHODS The aim of this two-arm open-label randomized controlled trial is to examine the effectiveness of an online, self-guided integrated treatment for problem gambling and tobacco smoking. A target sample of 214 participants will be recruited and be randomized into either an 8-week integrated or gambling only control condition. Both conditions will consist of seven online modules following cognitive behavioural therapy and motivational interviewing principles. Our three primary outcomes are (1) the number of days gambled, (2) money spent on gambling activities, and (3) time spent in gambling activities. Secondary outcomes include gambling disorder symptoms, cigarette use, and nicotine dependence symptoms. Assessments will be completed at baseline, at completion (i.e. 8 weeks from baseline), and at follow-up (i.e. 24 weeks from baseline). Generalized linear mixed modelling will be used to evaluate our primary and secondary outcomes. We expect that participants receiving online integrated treatment will show larger reductions in gambling relative to those receiving a control gambling only intervention. We further hypothesize that reductions in smoking will mediate these group differences. DISCUSSION The rates of problem gambling and tobacco smoking are high in North America; yet, the treatment options for both are limited, with no integrated treatments available. If supported, our pilot study will be a cost-effective and accessible way to improve treatments for co-occurring problem gambling and tobacco use. TRIAL REGISTRATION ClinicalTrials.gov NCT03614884 . Registered on August 3, 2019.
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Affiliation(s)
- Elena Bilevicius
- Department of Psychology, University of Manitoba, 190 Dysart Rd, Winnipeg, MB, R3T 2N2, Canada
| | - Alanna Single
- Department of Psychology, University of Manitoba, 190 Dysart Rd, Winnipeg, MB, R3T 2N2, Canada
| | - Chris Baumgartner
- Swiss Research Institute for Public Health and Addiction, University of Zurich, Konradstrasse 32, CH-8031, Zurich, Switzerland
| | - Van Bui
- Department of Psychology, University of Manitoba, 190 Dysart Rd, Winnipeg, MB, R3T 2N2, Canada
| | - Tyler Kempe
- Department of Psychology, University of Manitoba, 190 Dysart Rd, Winnipeg, MB, R3T 2N2, Canada
| | - Michael P Schaub
- Swiss Research Institute for Public Health and Addiction, University of Zurich, Konradstrasse 32, CH-8031, Zurich, Switzerland
| | - Sherry H Stewart
- Departments of Psychiatry and Psychology & Neuroscience, Dalhousie University, Abbie J Lane Building, 8th floor, 5909 Veteran's Memorial Lane, Halifax, NS, B3H 3A7, Canada
| | - James MacKillop
- Peter Boris Centre for Addictions Research McMaster University/St. Joseph's Healthcare Hamilton, 1280 Main St West, Hamilton, ON, L8S 4L8, Canada
| | - David C Hodgins
- Department of Psychology, University of Calgary, 2500 University D NW, Calgary, AB, T2N 1N4, Canada
| | - Jeffrey D Wardell
- Department of Psychiatry, University of Toronto, 250 College Street, Toronto, ON, M5T 1R8, Canada
| | - Roisin O'Connor
- Department of Psychology, Concordia University, 7141 Sherbrooke W., Montreal, Canada
| | - Jennifer Read
- Department of Psychology, University of Buffalo, 231 Park Hall, Buffalo, NY, 14260-4110, USA
| | | | - Christopher Sundstrom
- Department of Psychology, University of Regina, 3737 Wascana Parkway, Regina, SK, S4S 0A2, Canada
| | - Matthew T Keough
- Department of Psychology, York University, 4700 Keele St, North York, ON, M3J 1P3, Canada.
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12
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Ethier AR, Kim HS, Hodgins DC, McGrath DS. High Rollers: Correlates of Problematic Cocaine Use Among a Community Sample of Gamblers. J Gambl Stud 2020; 36:513-525. [PMID: 32219672 DOI: 10.1007/s10899-020-09943-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Over half of problem gamblers (PGs; i.e., individuals with an impulse to gamble despite negative consequences) experience a substance use disorder. Explanations for this high rate of comorbidity have included shared clinical and personality factors. While gambling has been associated with substance use disorders in general, relatively few studies have examined the comorbidity of gambling and cocaine use disorders. The current study aimed to address this gap in the literature by comparing the demographic (age, gender, ethnicity, marital status, educational attainment, and employment status), gambling (time and money spent gambling, gambling severity, and motives for gambling), psychological (depression, anxiety, stress, alcohol consumption, nicotine dependency) and personality (trait impulsivity) correlates in a sample of community gamblers with varying degrees of cocaine use; never, recreational, and problematic use as measured by the WHO Alcohol, Smoking and Substance Involvement Screening Test Version 3 (ASSIST-V3.0). Of the 562 participants, 9.3% (N = 51), reported problematic cocaine use. No differences were found between groups for demographic factors. Problematic cocaine users (PCUs) were more likely to be PGs in comparison to recreational users, and never users. They also presented with increased levels of trait impulsivity, depression, anxiety, stress, and alcohol consumption. These results emphasize the need for increased focus on comorbidity and treatment approaches specifically tailored for individuals with PG and PCU.
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Affiliation(s)
- Ashley R Ethier
- Department of Psychology, University of Calgary, Calgary, AB, Canada.
| | - Hyoun S Kim
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - David C Hodgins
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Daniel S McGrath
- Department of Psychology, University of Calgary, Calgary, AB, Canada
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13
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Ou H, Zhang Y, He W. Commentary: Clinical Improvements in Comorbid Gambling/Cocaine Use Disorder (GD/CUD) Patients Undergoing Repetitive Transcranial Magnetic Stimulation (rTMS). Front Neural Circuits 2020; 14:39. [PMID: 32848631 PMCID: PMC7396627 DOI: 10.3389/fncir.2020.00039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 05/29/2020] [Indexed: 11/28/2022] Open
Affiliation(s)
- Hang Ou
- Research Center of Brain and Cognitive Neuroscience, Liaoning Normal University, Dalian, China.,Key Laboratory of Brain and Cognitive Neuroscience, Liaoning Province, Shanghai, China
| | - Yi Zhang
- Shanghai Mental Health Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Weiqi He
- Research Center of Brain and Cognitive Neuroscience, Liaoning Normal University, Dalian, China.,Key Laboratory of Brain and Cognitive Neuroscience, Liaoning Province, Shanghai, China
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14
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Antons S, Brand M, Potenza MN. Neurobiology of cue-reactivity, craving, and inhibitory control in non-substance addictive behaviors. J Neurol Sci 2020; 415:116952. [DOI: 10.1016/j.jns.2020.116952] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 04/19/2020] [Accepted: 05/26/2020] [Indexed: 12/13/2022]
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15
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Miller L, Gordh AS. High Recreational Gamblers Show Increased Stimulatory Effects of an Acute Laboratory Gambling Challenge. J Gambl Stud 2020; 37:299-318. [PMID: 32406011 PMCID: PMC7882579 DOI: 10.1007/s10899-020-09952-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Gambling in moderation is a socially acceptable behavior and over 60% of the Swedish population gambles every year. It has been seen that slot machines are one of the most addictive and problematic forms of gambling and contribute highly to an addictive behavior.
It is unclear why some individuals intensify their gambling behavior over time to extreme levels while others do not. Initial positive response of a drug or as in this case a gambling behavior, most likely influences the likelihood of continuing use in non-addicted individuals. Therefore, we wanted to investigate if recreational gamblers show an altered subjective response to an online gambling challenge, e.g. to casino gambling. The present study was designed to examine the subjective effects after an acute gambling challenge, in healthy recreational gamblers compared with non-gamblers. Eighty-two subjects participated in the study. They were challenged with an acute online slot machine gambling challenge and self-report questionnaires of mood and blood pressure were taken before and after gambling. The gamblers, and more specifically the high recreational gamblers, reported increased stimulative effects after the gambling challenge in comparison to the non-gamblers. Findings suggests that gamblers experience significantly higher arousal effects to an acute online slot machine challenge. This response may be a uniquely predictive behavior for increased risk of gambling addiction.
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Affiliation(s)
- L Miller
- Addiction Biology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Blå stråket 15, SU/Sahlgrenska, 413 45, Gothenburg, Sweden.
| | - A Söderpalm Gordh
- Addiction Biology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Blå stråket 15, SU/Sahlgrenska, 413 45, Gothenburg, Sweden.,Beroendekliniken, Sahlgrenska University Hospital, 413 45, Gothenburg, Sweden
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16
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Mascia P, Wang Q, Brown J, Nesbitt KM, Kennedy RT, Vezina P. Maladaptive consequences of repeated intermittent exposure to uncertainty. Prog Neuropsychopharmacol Biol Psychiatry 2020; 99:109864. [PMID: 31952958 PMCID: PMC7107980 DOI: 10.1016/j.pnpbp.2020.109864] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 01/13/2020] [Accepted: 01/13/2020] [Indexed: 12/28/2022]
Abstract
Recently we reported that nucleus accumbens (NAcc) dopamine (DA) tracks uncertainty during operant responding for non-caloric saccharin. We also showed that repeated intermittent exposure to this uncertainty, like exposure to drugs of abuse, leads to sensitization of the locomotor and NAcc DA effects of amphetamine and promotes the subsequent self-administration of the drug. Here we review these findings together with others showing that NAcc glutamate signaling is similarly affected by uncertainty. Extracellular levels of glutamate in this site also track uncertainty in a task in which nose poking for saccharin on an escalating variable ratio schedule of reinforcement is associated with progressively increasing variance between performance of the operant and payout. Furthermore, sensitized behavioral responding to and for amphetamine following exposure to uncertainty is accompanied by increased levels of Ca2+/calmodulin-dependent protein kinase II (CaMKII) and protein kinase C (PKC) phosphorylation as well as altered protein levels of the transcription factor ∆FosB (increased) and glutamate transporter 1 (GLT1; decreased) in NAcc tissues. Notably, phosphorylation by CaMKII and PKC regulates AMPA receptor trafficking and function in this site, is elevated following psychostimulant exposure, and is necessary for the expression of enhanced drug taking. Increased ∆FosB and decreased GLT1 levels are observed following psychostimulant exposure, are associated with increased drug taking and seeking, and are known to modulate AMPA receptors and extracellular glutamate levels respectively. These adaptations in glutamate transmission as well as those observed with DA following repeated intermittent exposure to uncertainty are similar to those produced by exposure to abused drugs. Together, they point to the recruitment of both DA and glutamate signaling pathways in the NAcc in both drug and behavioral addictions. As uncertainty is central to games of chance, these findings have particular relevance for gambling disorders known to exhibit comorbidity with drug abuse.
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Affiliation(s)
- Paola Mascia
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, Chicago, IL, United States
| | - Qiang Wang
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, Chicago, IL, United States
| | - Jason Brown
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, Chicago, IL, United States
| | - Kathryn M Nesbitt
- Department of Chemistry, Towson University, Towson, MD, United States
| | - Robert T Kennedy
- Department of Chemistry, University of Michigan, Ann Arbor, MI, United States
| | - Paul Vezina
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, Chicago, IL, United States.
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17
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Effects of 5-HT 2C, 5-HT 1A receptor challenges and modafinil on the initiation and persistence of gambling behaviours. Psychopharmacology (Berl) 2020; 237:1745-1756. [PMID: 32123974 PMCID: PMC7239826 DOI: 10.1007/s00213-020-05496-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 02/19/2020] [Indexed: 11/07/2022]
Abstract
RATIONALE Problematic patterns of gambling are characterised by loss of control and persistent gambling often to recover losses. However, little is known about the mechanisms that mediate initial choices to begin gambling and then continue to gamble in the face of losing outcomes. OBJECTIVES These experiments first assessed gambling and loss-chasing performance under different win/lose probabilities in C57Bl/6 mice, and then investigated the effects of antagonism of 5-HT2CR with SB242084, 5-HT1AR agonism with 8-OH-DPAT and modafinil, a putative cognitive enhancer. RESULTS As seen in humans and other species, mice demonstrated the expected patterns of behaviour as the odds for winning were altered increasing gambling and loss-chasing when winning was more likely. SB242084 decreased the likelihood to initially gamble, but had no effects on subsequent gambling choices in the face of repeated losses. In contrast, 8-OH-DPAT had no effects on choosing to gamble in the first place, but once started 8-OH-DPAT increased gambling choices in a dose-sensitive manner. Modafinil effects were different to the serotonergic drugs in both decreasing the propensity to initiate gambling and chase losses. CONCLUSIONS We present evidence for dissociable effects of systemic drug administration on different aspects of gambling behaviour. These data extend and reinforce the importance of serotonergic mechanisms in mediating discrete components of gambling behaviour. They further demonstrate the ability of modafinil to reduce gambling behaviour. Our work using a novel mouse paradigm may be of utility in modelling the complex psychological and neurobiological underpinnings of gambling problems, including the analysis of genetic and environmental factors.
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Polygenic Risk Scores for Psychiatric Disorders Reveal Novel Clues About the Genetics of Disordered Gambling. Twin Res Hum Genet 2019; 22:283-289. [PMID: 31608857 DOI: 10.1017/thg.2019.90] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Disordered gambling (DG) is a rare but serious condition that results in considerable financial and interpersonal harms. Twin studies indicate that DG is heritable but are silent with respect to specific genes or pathways involved. Existing genomewide association studies (GWAS) of DG have been substantially underpowered. Larger GWAS of other psychiatric disorders now permit calculation of polygenic risk scores (PRSs) that reflect the aggregated effects of common genetic variants contributing risk for the target condition. The current study investigated whether gambling and DG are associated with PRSs for four psychiatric conditions found to be comorbid with DG in epidemiologic surveys: major depressive disorder (MDD), attention-deficit hyperactivity disorder (ADHD), bipolar disorder (BD) and schizophrenia (SCZ). Genotype data and survey responses were analyzed from the Wave IV assessment (conducted in 2008) of the National Longitudinal Study of Adolescent to Adult Health, a representative sample of adolescents recruited in 1994-1995 and followed into adulthood. Among participants classified as having European ancestry based on genetic analysis (N = 5215), 78.4% reported ever having gambled, and 1.3% reported lifetime DG. Polygenic risk for BD was associated with decreased odds of lifetime gambling, OR = 0.93 [0.87, 0.99], p = .045, pseudo-R2(%) = .12. The SCZ PRS was associated with increased odds of DG, OR = 1.54 [1.07, 2.21], p = .02, pseudo-R2(%) = .85. Polygenic risk scores for MDD and ADHD were not related to either gambling outcome. Investigating features common to both SCZ and DG might generate valuable clues about the genetically influenced liabilities to DG.
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19
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Zack M, Lobo D, Biback C, Fang T, Smart K, Tatone D, Kalia A, Digiacomo D, Kennedy JL. Impulsivity moderates the effects of dopamine D2 and mixed D1-D2 antagonists in individuals with gambling disorder. J Psychopharmacol 2019; 33:1015-1029. [PMID: 31219367 DOI: 10.1177/0269881119855972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The functional role of dopamine D1 and D2 receptors in gambling disorder (GD) remains unclear. AIMS This study aimed to investigate the role of D1 activation and the moderating effects of impulsivity, a trait linked with weaker D2-mediated inhibition of dopamine release, in GD subjects. METHODS Thirty (nine female) non-comorbid GD subjects with low (LI), moderate (MI), or high impulsivity (HI) received the preferential D2 antagonist haloperidol (HAL; 3 mg) or the mixed D1-D2 antagonist fluphenazine (FLU; 3 mg), on separate sessions before a 15-minute slot machine game or amphetamine (AMPH; 20 mg), in a placebo-controlled, double-blind, counterbalanced design. RESULTS On their own, HAL and FLU led to linear increases and decreases, respectively, in desire to gamble across increasing levels of impulsivity. The slot machine and AMPH each evoked an inverted-U pattern of desire to gamble across increasing impulsivity. HAL reversed this effect of the game, whereas FLU did not alter post-game desire. HAL and FLU decreased and increased psychostimulant-like effects of the game, respectively, in LI and MI subjects, but consistently reduced these effects in HI subjects. HAL also altered the salience of negative affective words on a reading task, such that greater salience of negative words coincided with lower post-game desire to gamble. CONCLUSIONS D1 receptors appear to gauge the incentive value of gambling in GD subjects. D1 activation has negative reinforcing effects in HI gamblers and positive reinforcing effects in LI gamblers. Medications that activate D1 could curtail chasing in HI gamblers. D1 blockade could benefit HI gamblers whose main concern is craving.
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Affiliation(s)
- Martin Zack
- 1 Molecular Brain Sciences Research Department, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada.,2 Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
| | - Daniela Lobo
- 1 Molecular Brain Sciences Research Department, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada.,3 Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Candice Biback
- 2 Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada.,4 Leslie Dan School of Pharmacy, University of Toronto, Toronto, ON, Canada
| | - Tim Fang
- 2 Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
| | - Kelly Smart
- 2 Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
| | - Daniel Tatone
- 2 Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
| | - Aditi Kalia
- 2 Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
| | - Daniel Digiacomo
- 3 Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - James L Kennedy
- 1 Molecular Brain Sciences Research Department, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada.,3 Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,5 Institute of Medical Science, University of Toronto, Toronto, ON, Canada
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20
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Abstract
Gambling disorder is characterized by a persistent, recurrent pattern of gambling that is associated with substantial distress or impairment. The prevalence of gambling disorder has been estimated at 0.5% of the adult population in the United States, with comparable or slightly higher estimates in other countries. The aetiology of gambling disorder is complex, with implicated genetic and environmental factors. Neurobiological studies have implicated cortico-striato-limbic structures and circuits in the pathophysiology of this disorder. Individuals with gambling disorder often go unrecognized and untreated, including within clinical settings. Gambling disorder frequently co-occurs with other conditions, particularly other psychiatric disorders. Behavioural interventions, particularly cognitive-behavioural therapy but also motivational interviewing and Gamblers Anonymous, are supported in the treatment of gambling disorder. No pharmacological therapy has a formal indication for the treatment of gambling disorder, although placebo-controlled trials suggest that some medications, such as opioid-receptor antagonists, may be helpful. Given the associations with poor quality of life and suicide, improved identification, prevention, policy and treatment efforts are needed to help people with gambling disorder.
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21
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Facilitated attention for gambling cues in adolescent problem gamblers: An experimental study. J Affect Disord 2019; 252:39-46. [PMID: 30978623 DOI: 10.1016/j.jad.2019.04.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 02/20/2019] [Accepted: 04/06/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Studies investigating attentional biases in gambling have observed that problem gamblers' attention is biased toward gambling cues. Despite the increase of gambling among adolescents, to date, no study has ever examined the role of attentional bias in adolescent gambling, as well as the relationships between adolescent gambling severity, craving, and alcohol use. METHODS The present study comprised 87 adolescent participants. Based on South Oaks Gambling Screen Revised for Adolescents (SOGS-RA) scores, participants were assigned to non-problem or problem gamblers groups. Participants performed a modified Posner Task (with cue presentation times at 100 and 500 ms) to assess attentional biases. Following the experiment, participants completed the Gambling Craving Scale (GACS) and the Alcohol Use Disorders Identification Test (AUDIT). RESULTS Compared to non-problem gamblers, problem gamblers displayed facilitation bias for gambling cues at 500 ms and reported higher levels of craving and alcohol consumption. Results also indicated that alcohol use correlated with facilitation bias. LIMITATIONS The recruitment of a predominantly male sample and the use of an indirect measure of attentional bias may have affected the findings concerning attentional processes. CONCLUSIONS The present study provides the first empirical evidence of attentional processes in adolescent gambling, and confirms the role of attentional biases, craving, and alcohol use being associated factors in adolescent problem gambling. The results of the present study stress the importance of attentional biases in the initial stages of problem gambling and suggest the need for clinical interventions aimed at reducing attentional bias before they became automatic. Overall, the present study stressed the role of attentional bias as both facilitator and a consequence of gambling involvement.
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22
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Exposure to conditions of uncertainty promotes the pursuit of amphetamine. Neuropsychopharmacology 2019; 44:274-280. [PMID: 29875447 PMCID: PMC6300556 DOI: 10.1038/s41386-018-0099-4] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Revised: 04/19/2018] [Accepted: 05/16/2018] [Indexed: 12/11/2022]
Abstract
Prior exposure to abused drugs leads to long-lasting neuroadaptations culminating in excessive drug intake. Given the comorbidity between substance use and gambling disorders, surprisingly little is known about the effects of exposure to reinforcement contingencies experienced during games of chance. As it is a central feature of these games, we characterized the effects of exposure to uncertainty on biochemical and behavioral effects normally observed in rats exposed to amphetamine. Rats in different groups were trained to nose-poke for saccharin under certain [fixed-ratio (FR)] or uncertain conditions [variable-ratio (VR)] for 55 1-h sessions. Ratios were escalated on successive sessions and rats maintained on the last ratio (FR/VR 20) for 20-25 days. Two to three weeks later, rats were tested for their locomotor or nucleus accumbens dopamine (NAcc DA) response to amphetamine or self-administration of the drug using a lever press operant. NAcc DA overflow was also assessed in additional rats during the saccharin sessions. Rats exposed to uncertainty subsequently showed a higher locomotor and NAcc DA response to amphetamine and self-administered more drug infusions relative to rats exposed to predictable reinforcement. NAcc DA levels during the saccharin sessions tracked the variance of the scheduled ratios (a measure of uncertainty). VR rats showed escalating DA overflow with increasing ratios. Exposure to uncertainty triggered neuroadaptations similar to those produced by exposure to abused drugs. As these were produced in drug naive rats both during and after exposure to uncertainty, they provide a novel common pathway to drug and behavioral addictions.
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23
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Richard J, Potenza MN, Ivoska W, Derevensky J. The Stimulating Nature of Gambling Behaviors: Relationships Between Stimulant Use and Gambling Among Adolescents. J Gambl Stud 2018; 35:47-62. [DOI: 10.1007/s10899-018-9778-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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24
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Amphetamine primes enhanced motivation toward uncertain choices in rats with genetic alcohol preference. Psychopharmacology (Berl) 2018; 235:1361-1370. [PMID: 29427080 DOI: 10.1007/s00213-018-4847-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 01/31/2018] [Indexed: 12/21/2022]
Abstract
RATIONALE Comorbidity with gambling disorder (GD) and alcohol use disorder (AUD) is well documented. OBJECTIVE The purpose of our study was to examine the influence of genetic alcohol drinking tendency on reward-guided decision making behavior of rats and the impact of dopamine releaser D-amphetamine on this behavior. METHODS In this study, Alko alcohol (AA) and Wistar rats went through long periods of operant lever pressing training where the task was to choose the profitable of two options. The lever choices were guided by different-sized sucrose rewards (one or three pellets), and the probability of gaining the larger reward was slowly changed to a level where choosing the smaller reward would be the most profitable in the long run. After training, rats were injected (s.c.) with dopamine releaser D-amphetamine (0.3, 1.0 mg/kg) to study the impact of rapid dopamine release on this learned decision making behavior. RESULTS Administration of D-amphetamine promoted unprofitable decision making of AA rats more robustly when compared to Wistar rats. At the same time, D-amphetamine reduced lever pressing responses. Interestingly, we found that this reduction in lever pressing was significantly greater in Wistar rats than in AA rats and it was not linked to motivation to consume sucrose. CONCLUSIONS Our results indicate that conditioning to the lever pressing in uncertain environments is more pronounced in AA than in Wistar rats and indicate that the reinforcing effects of a gambling-like environment act as a stronger conditioning factor for rats that exhibit a genetic tendency for high alcohol drinking.
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25
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McGrath DS, Meitner A, Sears CR. The specificity of attentional biases by type of gambling: An eye-tracking study. PLoS One 2018; 13:e0190614. [PMID: 29385164 PMCID: PMC5791982 DOI: 10.1371/journal.pone.0190614] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 12/18/2017] [Indexed: 02/03/2023] Open
Abstract
A growing body of research indicates that gamblers develop an attentional bias for gambling-related stimuli. Compared to research on substance use, however, few studies have examined attentional biases in gamblers using eye-gaze tracking, which has many advantages over other measures of attention. In addition, previous studies of attentional biases in gamblers have not directly matched type of gambler with personally-relevant gambling cues. The present study investigated the specificity of attentional biases for individual types of gambling using an eye-gaze tracking paradigm. Three groups of participants (poker players, video lottery terminal/slot machine players, and non-gambling controls) took part in one test session in which they viewed 25 sets of four images (poker, VLTs/slot machines, bingo, and board games). Participants' eye fixations were recorded throughout each 8-second presentation of the four images. The results indicated that, as predicted, the two gambling groups preferentially attended to their primary form of gambling, whereas control participants attended to board games more than gambling images. The findings have clinical implications for the treatment of individuals with gambling disorder. Understanding the importance of personally-salient gambling cues will inform the development of effective attentional bias modification treatments for problem gamblers.
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Affiliation(s)
- Daniel S. McGrath
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
| | - Amadeus Meitner
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
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26
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Neural correlates of cognitive control in gambling disorder: a systematic review of fMRI studies. Neurosci Biobehav Rev 2017; 78:104-116. [DOI: 10.1016/j.neubiorev.2017.04.025] [Citation(s) in RCA: 109] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Revised: 04/18/2017] [Accepted: 04/22/2017] [Indexed: 12/21/2022]
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27
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Takeuchi H, Tsurumi K, Murao T, Takemura A, Kawada R, Urayama SI, Aso T, Sugihara GI, Miyata J, Murai T, Takahashi H. Common and differential brain abnormalities in gambling disorder subtypes based on risk attitude. Addict Behav 2017; 69:48-54. [PMID: 28131932 DOI: 10.1016/j.addbeh.2017.01.025] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 12/13/2016] [Accepted: 01/20/2017] [Indexed: 12/18/2022]
Abstract
Studying brain abnormalities in behavioral addiction including GD enables us to exclude possible confounding effects of exposure to neurotoxic substances, which should provide important insight that can lead to a better understanding of addiction per se. There have been a few brain structural magnetic resonance imaging studies for GD, although the results have been inconsistent. On the other hand, GD was suggested to be a heterogeneous disorder in terms of risk attitude. We aimed to examine the heterogeneity of GD by combining a behavioral economics task and voxel-based morphometry. Thirty-six male GD patients and 36 healthy male control subjects underwent a task for estimation of loss aversion, which can assess risk attitude in real-life decision-making. The GD patients were divided into two groups based on their level of loss aversion, low and high. While both groups showed common gray matter volume reduction in the left supramarginal gyrus and bilateral posterior cerebellum, high loss-aversion GD showed pronounced reduction in the left posterior cerebellum and additional reduction in the bilateral medial orbitofrontal cortex. Our study suggests that the heterogeneity of GD is underpinned at the brain structural level. This result might be useful for understanding neurobiological mechanisms and for the establishment of precise treatment strategies for GD.
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Affiliation(s)
- Hideaki Takeuchi
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Kosuke Tsurumi
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Takuro Murao
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Ariyoshi Takemura
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Ryosaku Kawada
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Shin-Ichi Urayama
- Human Brain Research Center, Graduate School of Medicine, Kyoto University, Yoshida-Konoe-cho, Sakyo-ku, Kyoto 606-8501, Japan
| | - Toshihiko Aso
- Human Brain Research Center, Graduate School of Medicine, Kyoto University, Yoshida-Konoe-cho, Sakyo-ku, Kyoto 606-8501, Japan
| | - Gen-Ichi Sugihara
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Jun Miyata
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Toshiya Murai
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Hidehiko Takahashi
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.
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28
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Hloch K, Mladěnka P, Doseděl M, Adriani W, Zoratto F. The current clinical knowledge on the treatment of gambling disorder: A summary. Synapse 2017; 71. [DOI: 10.1002/syn.21976] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Revised: 03/14/2017] [Accepted: 03/14/2017] [Indexed: 02/04/2023]
Affiliation(s)
- Karel Hloch
- Department of Social and Clinical Pharmacy; Faculty of Pharmacy, Charles University; Heyrovskeho 1203 Hradec Kralove 500 05 Czech Republic
| | - Přemysl Mladěnka
- Department of Pharmacology and Toxicology; Faculty of Pharmacy, Charles University; Heyrovskeho 1203 Hradec Kralove 500 05 Czech Republic
| | - Martin Doseděl
- Department of Social and Clinical Pharmacy; Faculty of Pharmacy, Charles University; Heyrovskeho 1203 Hradec Kralove 500 05 Czech Republic
| | - Walter Adriani
- Centre for Behavioural Sciences and Mental Health; Istituto Superiore di Sanità; Viale Regina Elena 299 Rome I-00161 Italy
| | - Francesca Zoratto
- Unit of Cognitive Primatology and Primate Centre; Institute of Cognitive Sciences and Technologies of the National Research Council of Italy; Via Ulisse Aldrovandi 16/B Rome I-00197 Italy
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Nautiyal KM, Okuda M, Hen R, Blanco C. Gambling disorder: an integrative review of animal and human studies. Ann N Y Acad Sci 2017; 1394:106-127. [PMID: 28486792 PMCID: PMC5466885 DOI: 10.1111/nyas.13356] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 03/08/2017] [Accepted: 03/22/2017] [Indexed: 11/29/2022]
Abstract
Gambling disorder (GD), previously called pathological gambling and classified as an impulse control disorder in DSM-III and DSM-IV, has recently been reclassified as an addictive disorder in the DSM-5. It is widely recognized as an important public health problem associated with substantial personal and social costs, high rates of psychiatric comorbidity, poor physical health, and elevated suicide rates. A number of risk factors have been identified, including some genetic polymorphisms. Animal models have been developed in order to study the underlying neural basis of GD. Here, we discuss recent advances in our understanding of the risk factors, disease course, and pathophysiology. A focus on a phenotype-based dissection of the disorder is included in which known neural correlates from animal and human studies are reviewed. Finally, current treatment approaches are discussed, as well as future directions for GD research.
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Affiliation(s)
- Katherine M. Nautiyal
- New York State Psychiatric Institute, New York, New York
- Department of Psychiatry, Columbia University, New York, New York
| | - Mayumi Okuda
- New York State Psychiatric Institute, New York, New York
- Department of Psychiatry, Columbia University, New York, New York
| | - Rene Hen
- New York State Psychiatric Institute, New York, New York
- Department of Psychiatry, Columbia University, New York, New York
- Departments of Neuroscience and Pharmacology, Columbia University, New York, New York
| | - Carlos Blanco
- National Institute on Drug Abuse, Rockville, Maryland
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Takeuchi H, Kawada R, Tsurumi K, Yokoyama N, Takemura A, Murao T, Murai T, Takahashi H. Heterogeneity of Loss Aversion in Pathological Gambling. J Gambl Stud 2017; 32:1143-1154. [PMID: 26711104 PMCID: PMC5101258 DOI: 10.1007/s10899-015-9587-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Pathological gambling (PG) is characterized by continual repeated gambling behavior despite negative consequences. PG is considered to be a disorder of altered decision-making under risk, and behavioral economics tools were utilized by studies on decision-making under risk. At the same time, PG was suggested to be a heterogeneous disorder in terms of personality traits as well as risk attitude. We aimed to examine the heterogeneity of PG in terms of loss aversion, which means that a loss is subjectively felt to be larger than the same amount of gain. Thirty-one male PG subjects and 26 male healthy control (HC) subjects underwent a behavioral economics task for estimation of loss aversion and personality traits assessment. Although loss aversion in PG subjects was not significantly different from that in HC subjects, distributions of loss aversion differed between PG and HC subjects. HC subjects were uniformly classified into three levels (low, middle, high) of loss aversion, whereas PG subjects were mostly classified into the two extremes, and few PG subjects were classified into the middle range. PG subjects with low and high loss aversion showed a significant difference in anxiety, excitement-seeking and craving intensity. Our study suggested that PG was a heterogeneous disorder in terms of loss aversion. This result might be useful for understanding cognitive and neurobiological mechanisms and the establishment of treatment strategies for PG.
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Affiliation(s)
- Hideaki Takeuchi
- Department of Psychiatry, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 6068507, Japan
| | - Ryosaku Kawada
- Department of Psychiatry, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 6068507, Japan
| | - Kosuke Tsurumi
- Department of Psychiatry, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 6068507, Japan
| | - Naoto Yokoyama
- Department of Psychiatry, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 6068507, Japan
| | - Ariyoshi Takemura
- Department of Psychiatry, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 6068507, Japan
| | - Takuro Murao
- Department of Psychiatry, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 6068507, Japan
| | - Toshiya Murai
- Department of Psychiatry, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 6068507, Japan
| | - Hidehiko Takahashi
- Department of Psychiatry, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 6068507, Japan.
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Geisner IM, Huh D, Cronce JM, Lostutter TW, Kilmer J, Larimer ME. Exploring the Relationship Between Stimulant Use and Gambling in College Students. J Gambl Stud 2017; 32:1001-16. [PMID: 26691633 DOI: 10.1007/s10899-015-9586-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Both gambling and stimulant use are common and can lead to problems on college campuses with consequences that impact the financial, emotional, academic and physical well-being of students. Yet few studies have been conducted to understand the co-occurrence of these conditions and the increased risk factors if any that may exist for gambling and related problems. The present study is among the first to document the co-occurrence of these behaviors in both a random sample of students (N = 4640), and then to explore to what extent stimulant use impacts subsequent gambling and related problems 12 months later in an at-risk sample (N = 199). Results revealed a three-fold higher rate of recent problem gambling for those who used stimulants versus those who had not (11 vs. 4 %). For those already gambling, stimulant use predicted an increased frequency in gambling 12 months later. Implications for prevention and screening are discussed.
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Affiliation(s)
- Irene Markman Geisner
- Department of Psychiatry and Behavioral Sciences, Center for the Study of Health and Risk Behaviors, University of Washington, 1100 NE 45th St, Suite 300, Box 354944, Seattle, WA, 98195, USA.
| | - David Huh
- Department of Psychiatry and Behavioral Sciences, Center for the Study of Health and Risk Behaviors, University of Washington, 1100 NE 45th St, Suite 300, Box 354944, Seattle, WA, 98195, USA
| | - Jessica M Cronce
- Department of Psychiatry and Behavioral Sciences, Center for the Study of Health and Risk Behaviors, University of Washington, 1100 NE 45th St, Suite 300, Box 354944, Seattle, WA, 98195, USA
| | - Ty W Lostutter
- Department of Psychiatry and Behavioral Sciences, Center for the Study of Health and Risk Behaviors, University of Washington, 1100 NE 45th St, Suite 300, Box 354944, Seattle, WA, 98195, USA
| | - Jason Kilmer
- Department of Psychiatry and Behavioral Sciences, Center for the Study of Health and Risk Behaviors, University of Washington, 1100 NE 45th St, Suite 300, Box 354944, Seattle, WA, 98195, USA
| | - Mary E Larimer
- Department of Psychiatry and Behavioral Sciences, Center for the Study of Health and Risk Behaviors, University of Washington, 1100 NE 45th St, Suite 300, Box 354944, Seattle, WA, 98195, USA
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Chen M, Sun Y, Lu L, Shi J. Similarities and Differences in Neurobiology. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2017; 1010:45-58. [PMID: 29098667 DOI: 10.1007/978-981-10-5562-1_3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Substance addiction is a chronic, relapsing brain disease characterized by compulsive drug seeking and use despite harmful consequences. Non-substance addiction is defined recently that people may compulsively engage in an activity despite any negative consequences to their lives. Despite differences with respect to their addictive object, substance addiction and non-substance addiction may share similarities with respect to biological, epidemiological, clinical, genetic and other features. Here we review the similarities and differences in neurobiology between these two addictions with a focus on dopamine, serotonin, opioid, glutamate and norepinephrine systems. Studies suggest the involvement of all these systems in both substance addiction and non-substance addiction while differences may exist with respect to their contributions.
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Affiliation(s)
- Manli Chen
- Department of Pharmacology, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, 100191, China
- National Institute on Drug Dependence, Peking University, No. 38, Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Yan Sun
- National Institute on Drug Dependence, Peking University, No. 38, Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Lin Lu
- Institute of Mental Health/Peking University Sixth Hospital and National Clinical Research Center for Mental Disorders & Key Laboratory of Mental Health, Peking University, Beijing, 100191, China
| | - Jie Shi
- National Institute on Drug Dependence, Peking University, No. 38, Xueyuan Road, Haidian District, Beijing, 100191, China.
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Zack MH, Lobo DS, Biback C, Fang T, Smart K, Tatone D, Kalia A, Digiacomo D, Kennedy JL. Parallel role for the dopamine D1 receptor in gambling and amphetamine reinforcement in healthy volunteers. J Psychopharmacol 2017; 31:31-42. [PMID: 27624149 DOI: 10.1177/0269881116665329] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
This study investigated the role of dopamine, and specifically the D1 receptor (D1R), in the reinforcing effects of a slot-machine game in healthy volunteers ( n=30). To compare gambling and drug effects, subjects received the prototypic psychostimulant drug d-amphetamine (AMPH; 20 mg) in a multi-session, placebo-controlled design. To isolate D1R, half the subjects were pretreated with the preferential D2 receptor antagonist haloperidol (HAL; 3 mg), and the other half with the mixed D1-D2 antagonist fluphenazine (FLU; 3 mg) before the game (Phase I) and AMPH (Phase II). HAL decreased and FLU increased the post-game desire to gamble and post-AMPH desire to take AMPH again, as well as amphetamine scale ratings on the Addiction Research Center Inventory after gambling and AMPH. The effects of the antagonists on desire to gamble and to take AMPH again were significantly intercorrelated. HAL increased and FLU decreased the salience of negative affective words on a rapid reading task after both reinforcers. HAL also decreased the salience of gambling words after AMPH. Both reinforcers increased diastolic blood pressure equally under antagonists and placebo. Results indicate that D1R plays a parallel role in the psychostimulant-like, incentive-motivational, and salience-enhancing effects of gambling and AMPH. Moderate D1R activation appears to optimize these effects in healthy subjects.
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Affiliation(s)
- Martin H Zack
- Centre for Addiction and Mental Health, Toronto, Canada
| | | | | | - Tim Fang
- Centre for Addiction and Mental Health, Toronto, Canada
| | - Kelly Smart
- Centre for Addiction and Mental Health, Toronto, Canada
| | - Daniel Tatone
- Centre for Addiction and Mental Health, Toronto, Canada
| | - Aditi Kalia
- Centre for Addiction and Mental Health, Toronto, Canada
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Sescousse G, Janssen LK, Hashemi MM, Timmer MHM, Geurts DEM, ter Huurne NP, Clark L, Cools R. Amplified Striatal Responses to Near-Miss Outcomes in Pathological Gamblers. Neuropsychopharmacology 2016; 41:2614-23. [PMID: 27006113 PMCID: PMC4987843 DOI: 10.1038/npp.2016.43] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 02/17/2016] [Accepted: 03/18/2016] [Indexed: 01/06/2023]
Abstract
Near-misses in gambling games are losing events that come close to a win. Near-misses were previously shown to recruit reward-related brain regions including the ventral striatum, and to invigorate gambling behavior, supposedly by fostering an illusion of control. Given that pathological gamblers are particularly vulnerable to such cognitive illusions, their persistent gambling behavior might result from an amplified striatal sensitivity to near-misses. In addition, animal studies have shown that behavioral responses to near-miss-like events are sensitive to dopamine, but this dopaminergic influence has not been tested in humans. To investigate these hypotheses, we recruited 22 pathological gamblers and 22 healthy controls who played a slot machine task delivering wins, near-misses and full-misses, inside an fMRI scanner. Each participant played the task twice, once under placebo and once under a dopamine D2 receptor antagonist (sulpiride 400 mg), in a double-blind, counter-balanced design. Participants were asked about their motivation to continue gambling throughout the task. Across all participants, near-misses elicited higher motivation to continue gambling and increased striatal responses compared with full-misses. Crucially, pathological gamblers showed amplified striatal responses to near-misses compared with controls. These group differences were not observed following win outcomes. In contrast to our hypothesis, sulpiride did not induce any reliable modulation of brain responses to near-misses. Together, our results demonstrate that pathological gamblers have amplified brain responses to near-misses, which likely contribute to their persistent gambling behavior. However, there is no evidence that these responses are influenced by dopamine. These results have implications for treatment and gambling regulation.
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Affiliation(s)
- Guillaume Sescousse
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
- Department of Psychiatry, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Lieneke K Janssen
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
- Department of Psychiatry, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Mahur M Hashemi
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - Monique H M Timmer
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
- Department of Neurology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Dirk E M Geurts
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
- Department of Psychiatry, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Niels P ter Huurne
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
- Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, The Netherlands
| | - Luke Clark
- Department of Psychology, Centre for Gambling Research at UBC, University of British Columbia, Vancouver, British Columbia, Canada
| | - Roshan Cools
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
- Department of Psychiatry, Radboud University Medical Centre, Nijmegen, The Netherlands
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Ciccarelli M, Nigro G, Griffiths MD, Cosenza M, D'Olimpio F. Attentional biases in problem and non-problem gamblers. J Affect Disord 2016; 198:135-41. [PMID: 27016656 DOI: 10.1016/j.jad.2016.03.009] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Revised: 02/27/2016] [Accepted: 03/05/2016] [Indexed: 10/22/2022]
Abstract
BACKGROUND From a cognitive perspective, attentional biases are deemed as factors responsible in the onset and development of gambling disorder. However, knowledge relating to attentional processes in gambling is scarce and studies to date have reported contrasting results. Moreover, no study has ever examined which component and what type of bias are involved in attentional bias in gambling. METHODS In the present study, 108 Italian participants, equally divided into problem and non-problem gamblers, were administered a modified Posner Task, an attentional paradigm in which - through the manipulation of stimuli presentation time - it is possible to measure both initial orienting and maintenance of attention. In addition to the experimental task, participants completed self-report measures involving (i) craving (Gambling Craving Scale), (ii) depression, anxiety and stress (Depression Anxiety Stress Scale) and (iii) emotional dysregulation (Difficulties in Emotion Regulation Scale). RESULTS Analyses revealed facilitation in detecting gambling-related stimuli at the encoding level in problem gamblers but not in non-problem gamblers. Compared to non-problem gamblers, problem gamblers also reported higher levels of craving, emotional dysregulation, and negative mood states. Furthermore, all measures correlated with the gambling severity. LIMITATIONS The use of indirect measure of attentional bias could be less accurate compared to direct measures. CONCLUSIONS The facilitation in detecting gambling-related stimuli in problem gamblers and the correlation between subjective craving and facilitation bias suggests that attentional bias could not be due to a conditioning process but that motivational factors such as craving could induce addicted-related seeking-behaviors.
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Affiliation(s)
- Maria Ciccarelli
- Department of Psychology, Second University of Naples, Caserta, Italy.
| | - Giovanna Nigro
- Department of Psychology, Second University of Naples, Caserta, Italy
| | | | - Marina Cosenza
- Department of Psychology, Second University of Naples, Caserta, Italy
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Dopamine D3 Receptors Modulate the Ability of Win-Paired Cues to Increase Risky Choice in a Rat Gambling Task. J Neurosci 2016; 36:785-94. [PMID: 26791209 DOI: 10.1523/jneurosci.2225-15.2016] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Similar to other addiction disorders, the cues inherent in many gambling procedures are thought to play an important role in mediating their addictive nature. Animal models of gambling-related behavior, while capturing dimensions of economic decision making, have yet to address the impact that these salient cues may have in promoting maladaptive choice. Here, we determined whether adding win-associated audiovisual cues to a rat gambling task (rGT) would influence decision making. Thirty-two male Long-Evans rats were tested on either the cued or uncued rGT. In these tasks, animals chose between four options associated with different magnitudes and frequencies of reward and punishing time-out periods. As in the Iowa Gambling Task, favoring options associated with smaller per-trial rewards but smaller losses and avoiding the tempting "high-risk, high-reward" decks maximized profits. Although the reinforcement contingencies were identical in both task versions, rats' choice of the disadvantageous risky options was significantly greater on the cued task. Furthermore, a D3 receptor agonist increased choice of the disadvantageous options, whereas a D3 antagonist had the opposite effects, only on the cued task. These findings are consistent with the reported role of D3 receptors in mediating the facilitatory effects of cues in addiction. Collectively, these results indicate that the cued rGT is a valuable model with which to study the mechanism by which salient cues can invigorate maladaptive decision making, an important and understudied component of both gambling and substance use disorders. Significance statement: We used a rodent analog of the Iowa Gambling Task to determine whether the addition of audiovisual cues would affect choice preferences. Adding reward-concurrent cues significantly increased risky choice. This is the first clear demonstration that reward-paired cues can bias cost/benefit decision making against a subject's best interests in a manner concordant with elevated addiction susceptibility. Choice on the cued task was uniquely sensitive to modulation by D3 receptor ligands, yet these drugs did not alter decision making on the uncued task. The relatively unprecedented sensitivity of choice on the cued task to D3-receptor-mediated neurotransmission data suggest that similar neurobiological processes underlie the ability of cues to both bias animals toward risky options and facilitate drug addiction.
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Kohno M, Nurmi EL, Laughlin CP, Morales AM, Gail EH, Hellemann GS, London ED. Functional Genetic Variation in Dopamine Signaling Moderates Prefrontal Cortical Activity During Risky Decision Making. Neuropsychopharmacology 2016; 41:695-703. [PMID: 26119471 PMCID: PMC4707816 DOI: 10.1038/npp.2015.192] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Revised: 06/02/2015] [Accepted: 06/03/2015] [Indexed: 01/08/2023]
Abstract
Brain imaging has revealed links between prefrontal activity during risky decision-making and striatal dopamine receptors. Specifically, striatal dopamine D2-like receptor availability is correlated with risk-taking behavior and sensitivity of prefrontal activation to risk in the Balloon Analogue Risk Task (BART). The extent to which these associations, involving a single neurochemical measure, reflect more general effects of dopaminergic functioning on risky decision making, however, is unknown. Here, 65 healthy participants provided genotypes and performed the BART during functional magnetic resonance imaging. For each participant, dopamine function was assessed using a gene composite score combining known functional variation across five genes involved in dopaminergic signaling: DRD2, DRD3, DRD4, DAT1, and COMT. The gene composite score was negatively related to dorsolateral prefrontal cortical function during risky decision making, and nonlinearly related to earnings on the task. Iterative permutations of all possible allelic variations (7777 allelic combinations) was tested on brain function in an independently defined region of the prefrontal cortex and confirmed empirical validity of the composite score, which yielded stronger association than 95% of all other possible combinations. The gene composite score also accounted for a greater proportion of variability in neural and behavioral measures than the independent effects of each gene variant, indicating that the combined effects of functional dopamine pathway genes can provide a robust assessment, presumably reflecting the cumulative and potentially interactive effects on brain function. Our findings support the view that the links between dopaminergic signaling, prefrontal function, and decision making vary as a function of dopamine signaling capacity.
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Affiliation(s)
- Milky Kohno
- Department of Psychiatry and Biobehavioral Sciences and Semel Institute, University of California Los Angeles, Los Angeles, CA, USA
| | - Erika L Nurmi
- Department of Psychiatry and Biobehavioral Sciences and Semel Institute, University of California Los Angeles, Los Angeles, CA, USA
| | - Christopher P Laughlin
- Department of Psychiatry and Biobehavioral Sciences and Semel Institute, University of California Los Angeles, Los Angeles, CA, USA
| | - Angelica M Morales
- Department of Psychiatry and Biobehavioral Sciences and Semel Institute, University of California Los Angeles, Los Angeles, CA, USA
| | - Emma H Gail
- Department of Psychiatry and Biobehavioral Sciences and Semel Institute, University of California Los Angeles, Los Angeles, CA, USA
| | - Gerhard S Hellemann
- Department of Psychiatry and Biobehavioral Sciences and Semel Institute, University of California Los Angeles, Los Angeles, CA, USA
| | - Edythe D London
- Department of Psychiatry and Biobehavioral Sciences and Semel Institute, University of California Los Angeles, Los Angeles, CA, USA,Department of Molecular and Medical Pharmacology, University of California Los Angeles, Los Angeles, CA, USA,Brain Research Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA,Semel Institute of Neuroscience and Human Behavior, University of California Los Angeles, 760 Westwood Plaza, Los Angeles, CA 90024-1759, USA, Tel: +310 825 0606, Fax: +310 825 0812, E-mail:
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Abstract
Although most people consider gambling as a recreational activity, some individuals lose control over their behavior and enter a spiral of compulsive gambling leading to dramatic consequences. In its most severe form, pathological gambling is considered a behavioral addiction sharing many similarities with substance addiction. A number of neurobiological hypotheses have been investigated in the past ten years, relying mostly on neuroimaging techniques. Similarly to substance addiction, a number of observations indicate a central role for dopamine in pathological gambling. However, the underlying mechanism seems partly different and is still poorly understood. Neuropsychological studies have shown decision-making and behavioral inhibition deficits in pathological gamblers, likely reflecting frontal lobe dysfunction. Finally, functional MRI studies have revealed abnormal reactivity within the brain reward system, including the striatum and ventro-medial prefrontal cortex. These regions are over-activated by gambling cues, and under-activated by monetary gains. However, the scarcity and heterogeneity of brain imaging studies currently hinder the development of a coherent neurobiological model of pathological gambling. Further replications of results and diversification of approaches will be needed in the coming years in order to strengthen our current model.
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Affiliation(s)
- Guillaume Sescousse
- Radboud University Nijmegen, Donders Institute for Brain, Cognition and Behaviour, Kapittelweg 29 Box 9101, 6500 HB Nijmegen, Pays-Bas
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Guillot CR, Fanning JR, Liang T, Berman ME. COMT Associations with Disordered Gambling and Drinking Measures. J Gambl Stud 2015; 31:513-24. [PMID: 24390676 DOI: 10.1007/s10899-013-9434-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Disordered gambling and alcohol dependence are influenced by unique and shared genetic factors. Although the evidence is mixed, some research has linked catechol-O-methyltransferase (COMT) rs4680 (or COMT Val158Met) to the development of gambling or drinking problems; however, no molecular genetic study has jointly examined gambling and drinking problems. Furthermore, the majority of past studies examined gambling or drinking problems using a case-control design. The purpose of the current study was to examine associations of COMT rs4680 with dimensionally and categorically measured gambling and drinking problems in a nonclinical sample (139 Caucasian adults). The current study found that COMT rs4680 was related to both dimensionally and categorically measured gambling and drinking problems. It appears that the COMT Met/Met genotype may be a genetic risk factor that contributes to the development of both gambling and drinking problems.
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Affiliation(s)
- Casey R Guillot
- University of Southern California Keck School of Medicine, 2250 Alcazar St CSC 240, Los Angeles, CA, 90033, USA,
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Towards a Better Understanding of Disordered Gambling: Efficacy of Animal Paradigms in Modelling Aspects of Gambling Behaviour. CURRENT ADDICTION REPORTS 2015. [DOI: 10.1007/s40429-015-0065-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Single versus multiple impulse control disorders in Parkinson’s disease: an 11C-raclopride positron emission tomography study of reward cue-evoked striatal dopamine release. J Neurol 2015; 262:1504-14. [DOI: 10.1007/s00415-015-7722-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2015] [Revised: 03/24/2015] [Accepted: 03/25/2015] [Indexed: 01/16/2023]
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Leavens E, Marotta J, Weinstock J. Disordered gambling in residential substance use treatment centers: an unmet need. J Addict Dis 2015; 33:163-73. [PMID: 24735187 DOI: 10.1080/10550887.2014.909697] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This study examined prevalence and potential impact of disordered gambling in a sample of individuals (N = 684) undergoing residential treatment for substance use disorders at 13 facilities. Lifetime disordered gambling prevalence was 20.2%, as identified by South Oaks Gambling Screen. Within individuals who screened positive for disordered gambling, few had sought help for gambling (15.9%) and only 14.3% reported having gambling addressed in their current substance use disorder treatment. Meanwhile, 30.4% identified gambling as a concern in their recovery efforts. The presence of a gambling problem, either historical or current, potentially affects residential treatment outcomes and warrants clinical attention within these programs.
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Cocker P, Winstanley C. Irrational beliefs, biases and gambling: Exploring the role of animal models in elucidating vulnerabilities for the development of pathological gambling. Behav Brain Res 2015; 279:259-73. [DOI: 10.1016/j.bbr.2014.10.043] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Revised: 10/25/2014] [Accepted: 10/29/2014] [Indexed: 12/23/2022]
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Abstract
Addiction professionals and the public are recognizing that certain nonsubstance behaviors--such as gambling, Internet use, video-game playing, sex, eating, and shopping--bear resemblance to alcohol and drug dependence. Growing evidence suggests that these behaviors warrant consideration as nonsubstance or "behavioral" addictions and has led to the newly introduced diagnostic category "Substance-Related and Addictive Disorders" in DSM-5. At present, only gambling disorder has been placed in this category, with insufficient data for other proposed behavioral addictions to justify their inclusion. This review summarizes recent advances in our understanding of behavioral addictions, describes treatment considerations, and addresses future directions. Current evidence points to overlaps between behavioral and substance-related addictions in phenomenology, epidemiology, comorbidity, neurobiological mechanisms, genetic contributions, responses to treatments, and prevention efforts. Differences also exist. Recognizing behavioral addictions and developing appropriate diagnostic criteria are important in order to increase awareness of these disorders and to further prevention and treatment strategies.
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Grant JE, Odlaug BL, Schreiber LRN. Pharmacological treatments in pathological gambling. Br J Clin Pharmacol 2014; 77:375-81. [PMID: 22979951 DOI: 10.1111/j.1365-2125.2012.04457.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2012] [Accepted: 08/28/2012] [Indexed: 11/28/2022] Open
Abstract
Pathological gambling (PG) is a relatively common and often disabling psychiatric condition characterized by intrusive urges to engage in deleterious gambling behaviour. Although common and financially devastating to individuals and families, there currently exist no formally approved pharmacotherapeutic interventions for this disorder. This review seeks to examine the history of medication treatments for PG. A systematic review of the 18 double-blind, placebo-controlled pharmacotherapy studies conducted for the treatment of pathological gambling was conducted. Study outcome and the mean dose of medication administered was documented in an effort to determine a preferred medication choice in this population. A variety of medication classes have been examined in the treatment of PG with varying results. Antidepressants, atypical antipsychotics and mood stabilizers have demonstrated mixed results in controlled clinical trials. Although limited information is available, opioid antagonists and glutamatergic agents have demonstrated efficacious outcomes, especially for individuals with PG suffering from intense urges to engage in the behaviour. Given that several studies have demonstrated their efficacy in treating the symptoms associated with PG, opioid antagonists should be considered the first line treatment for PG at this time. Most published studies, however, have employed relatively small sample sizes, are of limited duration and involve possibly non-representative clinical groups (e.g. those without co-occurring psychiatric disorders). Response measures have varied across studies. Heterogeneity of PG treatment samples may also complicate identification of effective treatments. Identification of factors related to treatment response will help inform future studies and advance treatment strategies for PG.
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Affiliation(s)
- Jon E Grant
- Department of Psychiatry & Behavioral Neuroscience, University of Chicago, Chicago, Illinois, USA
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Potenza MN. The neural bases of cognitive processes in gambling disorder. Trends Cogn Sci 2014; 18:429-38. [PMID: 24961632 PMCID: PMC4112163 DOI: 10.1016/j.tics.2014.03.007] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2014] [Revised: 03/21/2014] [Accepted: 03/25/2014] [Indexed: 12/30/2022]
Abstract
Functional imaging is offering powerful new tools to investigate the neurobiology of cognitive functioning in people with and without psychiatric conditions like gambling disorder. Based on similarities between gambling and substance-use disorders in neurocognitive and other domains, gambling disorder has recently been classified in the Diagnostic and Statistical Manual of Mental Disorders (5th edn) (DSM-5) as a behavioral addiction. Despite the advances in understanding, there exist multiple unanswered questions about the pathophysiology underlying gambling disorder and the promise for translating the neurobiological understanding into treatment advances remains largely unrealized. Here we review the neurocognitive underpinnings of gambling disorder with a view to improving prevention, treatment, and policy efforts.
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Affiliation(s)
- Marc N Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; Department of Neurobiology, Yale University School of Medicine, New Haven, CT, USA; Child Study Center, Yale University School of Medicine, New Haven, CT, USA.
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Pharmacological treatments in gambling disorder: a qualitative review. BIOMED RESEARCH INTERNATIONAL 2014; 2014:537306. [PMID: 24955359 PMCID: PMC4052082 DOI: 10.1155/2014/537306] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Accepted: 04/23/2014] [Indexed: 12/17/2022]
Abstract
Gambling disorder (GD) is a psychiatric condition associated with both social and family costs; DSM-5 currently includes GD among addictive disorders. Despite the high burden of this condition, to date there are no treatment guidelines approved by Food and Drug Administration (FDA). Purpose of this paper is to offer a qualitative overview about the different pharmacologic agents used for the treatment of GD. Our analysis, conducted on a final selection of 75 scientific papers, demonstrates that a variety of pharmaceutical classes have been utilised, with different results. Published data, although limited by brief duration of the studies and small number of enrolled subjects, shows mixed evidence for serotonergic antidepressants, opioid antagonists, and mood stabilizers. Other compounds, such as glutamatergic agents and psychostimulants, deserve further studies.
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Xian H, Giddens JL, Scherrer JF, Eisen SA, Potenza MN. Environmental factors selectively impact co-occurrence of problem/pathological gambling with specific drug-use disorders in male twins. Addiction 2014; 109:635-44. [PMID: 24219015 PMCID: PMC3951667 DOI: 10.1111/add.12407] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Revised: 03/26/2013] [Accepted: 10/28/2013] [Indexed: 11/30/2022]
Abstract
AIMS Multiple forms of drug abuse/dependence frequently co-occur with problem/pathological gambling (PPG). The current study examines the extent to which genetic and environmental factors contribute to their co-occurrence. DESIGN Bivariate models investigated the magnitude and correlation of genetic and environmental contributions to problem/pathological gambling and its co-occurrence with nicotine dependence, cannabis abuse/dependence and stimulant abuse/dependence. SETTING Computer-assisted telephone interviews in the community. PARTICIPANTS Participants were 7869 male twins in the Vietnam Era Twin Registry, a USA-based national twin registry. MEASUREMENTS Life-time DSM-III-R diagnoses for problem/pathological gambling, nicotine dependence, cannabis abuse/dependence and stimulant abuse/dependence were determined using the Diagnostic Interview Schedule. FINDINGS All drug-use disorders displayed additive genetic and non-shared environmental contributions, with cannabis abuse/dependence also displaying shared environmental contributions. Both genetic [genetic correlation rA = 0.22; 95% confidence interval (CI) = 0.10-0.34] and non-shared environmental components (environmental correlation rE = 0.24; 95% CI = 0.10-0.37) contributed to the co-occurrence of problem/pathological gambling and nicotine dependence. This pattern was shared by cannabis abuse/dependence (rA = 0.32; 95% CI = 0.05-1.0; rE = 0.36; 95% CI = 0.16-0.55) but not stimulant abuse/dependence (SAD), which showed only genetic contributions to the co-occurrence with problem/pathological gambling (rA = 0.58; 95% CI = 0.45-0.73). CONCLUSIONS Strong links between gambling and stimulant-use disorders may relate to the neurochemical properties of stimulants or the illicit nature of using 'hard' drugs such as cocaine. The greater contribution of environmental factors to the co-occurrence between problem/pathological gambling and 'softer' forms of drug abuse/dependence (cannabis, tobacco) suggest that environmental interventions (perhaps relating to availability and legality) may help to diminish the relationship between problem/pathological gambling and tobacco- and cannabis-use disorders.
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Affiliation(s)
- Hong Xian
- Research Service 151-JC, St. Louis VAMC, 501 North Grand Blvd., Suite 300, St. Louis, MO, USA,Department of Biostatistics, Saint Louis University School of Public Health, Salus Center, St. Louis, MO, USA
| | - Justine L. Giddens
- Child Study Center, Yale University School of Medicine, New Haven, CT, USA,University of Toronto School of Medicine, ON, Canada
| | - Jeffrey F. Scherrer
- Research Service 151-JC, St. Louis VAMC, 501 North Grand Blvd., Suite 300, St. Louis, MO, USA,Family and Community Medicine, Saint Louis University School of Medicine, 1402 S. Grand, St. Louis, MO, USA
| | - Seth A. Eisen
- Veterans Health Administration, Office of Research and Development, Washington, DC
| | - Marc N. Potenza
- Child Study Center, Yale University School of Medicine, New Haven, CT, USA,Departments of Psychiatry and Neurobiology, Yale University School of Medicine, New Haven, CT, USA
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Chary M, Park EH, McKenzie A, Sun J, Manini AF, Genes N. Signs & symptoms of Dextromethorphan exposure from YouTube. PLoS One 2014; 9:e82452. [PMID: 24533044 PMCID: PMC3922701 DOI: 10.1371/journal.pone.0082452] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Accepted: 10/23/2013] [Indexed: 11/23/2022] Open
Abstract
Detailed data on the recreational use of drugs are difficult to obtain through traditional means, especially for substances like Dextromethorphan (DXM) which are available over-the-counter for medicinal purposes. In this study, we show that information provided by commenters on YouTube is useful for uncovering the toxicologic effects of DXM. Using methods of computational linguistics, we were able to recreate many of the clinically described signs and symptoms of DXM ingestion at various doses, using information extracted from YouTube comments. Our study shows how social networks can enhance our understanding of recreational drug effects.
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Affiliation(s)
- Michael Chary
- Ichan School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Emily H. Park
- Rutgers New Jersey Medical School, Newark, New Jersey, United States of America
| | - Andrew McKenzie
- Ichan School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Julia Sun
- Ichan School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Alex F. Manini
- Division of Medical Toxicology, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Nicholas Genes
- Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
- * E-mail:
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Zack M, Featherstone RE, Mathewson S, Fletcher PJ. Chronic exposure to a gambling-like schedule of reward predictive stimuli can promote sensitization to amphetamine in rats. Front Behav Neurosci 2014; 8:36. [PMID: 24574987 PMCID: PMC3920462 DOI: 10.3389/fnbeh.2014.00036] [Citation(s) in RCA: 87] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2013] [Accepted: 01/23/2014] [Indexed: 12/22/2022] Open
Abstract
Addiction is considered to be a brain disease caused by chronic exposure to drugs. Sensitization of brain dopamine (DA) systems partly mediates this effect. Pathological gambling (PG) is considered to be a behavioral addiction. Therefore, PG may be caused by chronic exposure to gambling. Identifying a gambling-induced sensitization of DA systems would support this possibility. Gambling rewards evoke DA release. One episode of slot machine play shifts the DA response from reward delivery to onset of cues (spinning reels) for reward, in line with temporal difference learning principles. Thus, conditioned stimuli (CS) play a key role in DA responses to gambling. In primates, DA response to a CS is strongest when reward probability is 50%. Under this schedule the CS elicits an expectancy of reward but provides no information about whether it will occur on a given trial. During gambling, a 50% schedule should elicit maximal DA release. This closely matches reward frequency (46%) on a commercial slot machine. DA release can contribute to sensitization, especially for amphetamine. Chronic exposure to a CS that predicts reward 50% of the time could mimic this effect. We tested this hypothesis in three studies with rats. Animals received 15 × 45-min exposures to a CS that predicted reward with a probability of 0, 25, 50, 75, or 100%. The CS was a light; the reward was a 10% sucrose solution. After training, rats received a sensitizing regimen of five separate doses (1 mg/kg) of d-amphetamine. Lastly they received a 0.5 or 1 mg/kg amphetamine challenge prior to a 90-min locomotor activity test. In all three studies the 50% group displayed greater activity than the other groups in response to both challenge doses. Effect sizes were modest but consistent, as reflected by a significant group × rank association (ϕ = 0.986, p = 0.025). Chronic exposure to a gambling-like schedule of reward predictive stimuli can promote sensitization to amphetamine much like exposure to amphetamine itself.
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Affiliation(s)
- Martin Zack
- Cognitive Psychopharmacology Laboratory, Neuroscience Department, Centre for Addiction and Mental Health Toronto, ON, Canada
| | - Robert E Featherstone
- Translational Neuroscience Program, Department of Psychiatry, School of Medicine, University of Pennsylvania Philadelphia, PA, USA
| | - Sarah Mathewson
- Biopsychology Section, Neuroscience Department, Centre for Addiction and Mental Health Toronto, ON, Canada
| | - Paul J Fletcher
- Biopsychology Section, Neuroscience Department, Centre for Addiction and Mental Health Toronto, ON, Canada
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